A Spectrum Approach to Mood Disorders: Not Fully Bipolar But Not Unipolar--Practical Management

by James Phelps MD

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Author: James Phelps MD

Publisher: W. W. Norton & Company

Hardcover:
ISBN 10: 0393711463
ISBN 13: 978-0393711462

How to understand your clients' true illnesses, not just their DSM checklists.

Though the DSM discusses the criteria for mood disorders in absolute terms―either present or absent―professionals are aware that while such dichotomies are useful for teaching, they are not always true in practice. Recent genetic data support clinicians' longstanding recognition that a continuum of mood disorders between unipolar and bipolar better matches reality than a yes/no, bipolar-or-not approach. If we acknowledge that continuum, how does this affect our approach to diagnosis and treatment?

In A Spectrum Approach to Mood Disorders, nationally recognized expert James Phelps provides an in-depth exploration of the signs, symptoms, and nuanced presentations of the mood disorder spectrum, focusing on the broad gray area between Major Depression and Bipolar I. Combining theoretical understanding and real-world scenarios, Phelps offers practical treatment guidelines for clinicians to better understand the subtle ways mood disorders can show up, and how to find the most beneficial path for treatment based on the patient's individual pattern of symptoms.

Is it trauma, or is it bipolar? Borderline? Both? Phelps's expertise and wealth of personal experience provides readers with unparalleled insight into a subject that is by nature challenging to define. His emphasis on non-medication approaches, as well as chapters on all the major pill-based treatments (from fish oil to lithium to the avoidance of atypical antipsychotics and antidepressants), creates a comprehensive resource for any clinician working with patients on the mood spectrum. Appendices on the relationship between bipolar diagnosis, politics, and religion; and a plain-English approach to the statistical perils of bipolar screening, offer further value.

Phelps has written an invaluable guide of the critical information professionals need to treat patients on the mood disorder spectrum, as well as a useful tool for highly motivated families and patients to better understand the mood disorder that effects their lives. This book seeks to alter the black and white language surrounding these mood disorders to influence a shift in how patients are diagnosed―to insure that treatment matches their specific needs.

Review

“[A] tremendous resource to help differentiate between cases of mood disorder or bipolar disorder. Dr. Phelps is a respected and highly-experienced physician. He presents a thorough and convincing explanation of the nuances of accepting that a broad spectrum of mood disorders does exist. Professionals who acknowledge this will be able to use Dr. Phelps’ book to provide patients with the focused, in-depth treatment they require.”
- PsychCentral

“Dr. James Phelps bravely enters territory that academia has largely neglected―the nebulous region between full bipolar disorder and major depression. . . . [A] must-read for any health professional involved in the treatment of affective illnesses, including psychiatrists, psychiatric nurse practitioners, psychologists, and therapists.”
- Psychiatric Times

“Engaging, wise, and superbly practical, this book addresses the complexity of the subject matter while providing an accessible guide for a range of health professionals to improve the treatment of mood disorders. The author integrates research and decades of clinical experience with a refreshing candor, inspiring you to think. The value of this book lies not only in the empowerment of the treating provider, but also in emphasizing the empowerment of the individual seeking treatment.”
- Lea Burns, PsyD, Primary Care Psychologist, Samaritan Family Medicine Resident Clinic

“James Phelps provides a guide for the perplexed. He analyzes the most complex, most common, and least understood aspect of clinical practice―the spectrum halfway between depression and mania. Many people suffer in that purgatory of diagnosis, neither truly bipolar nor unipolar, but they and their clinicians don't realize it. They should read this book. One can hope that future readers can look back on it as a key step towards ending an old and long period of clinical confusion.”
- Nassir Ghaemi, MD, MPH, Professor of Psychiatry, Director, Mood Disorders Program, Tufts Medical Center

“James Phelps' seminal work establishes a clear description of bipolarity and mood, moving us beyond the limitations of a binary construct. This excellent lens provides for greater diagnostic accuracy by including those with undiagnosed and/or mis-diagnosed mood traits. Dr. Phelps has created an essential tool-kit with a range of non-pharmacological and pharmacological interventions to improve the quality of life and outcomes for those with bipolar symptoms.”
- Lynnea Lindsey-Pengelly, PhD, MSCP, Medical Services Director, Trillium Behavioral Health

“How we think about recognizing and treating mood disturbances profoundly impacts how we treat them. And nowhere is there more confusion in clinical psychiatry than at the meeting point of mania and depression. James Phelps’ impressive new book A Spectrum Approach to Mood Disorders goes a long way toward ending the confusion and helping the mental health clinician take a balanced and reasoned approach to the treatment of the many patients who show a range of mood disturbances over time. It should be mandatory reading for everyone about to prescribe, or take, an antidepressant or mood stabilizer.”
- Charles Raison, MD, Mary Sue and Mike Shannon Chair for Healthy Minds, Children & Families; Professor, Department of Psychiatry, University of Wisconsin-Madison

About the Author

James Phelps, MD, is director of the Mood Disorders program at Samaritan Mental Health in Corvallis, Oregon, which serves a five-hospital system. Prior to joining Samaritan Mental Health, Dr. Phelps held a private practice in Corvallis while writing an internationally known website, PsychEducation.org, and teaching across the U.S. He is recognized as a national expert on the topic of bipolar disorder, and has published more than 15 books and journal articles pertaining to mental health.